- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,830.00 / $20,928.72
| Facility | | $5,463.36 | $10,830.00 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $8,056.00 / $8,056.00 / $8,056.00
| Facility | 50 | $8,056.00 | $8,056.00 | $8,056.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,183.05 / $10,762.95 / $20,819.02
| Facility | | $8,183.05 | $10,762.95 | $20,819.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,184.61 / $7,184.61 / $7,184.61
| Facility | | $7,184.61 | $7,184.61 | $7,184.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $962.35 / $1,732.23 / $10,575.11
| Facility | | $962.35 | $1,732.23 | $10,575.11 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $271.67 / $2,575.09 / $2,575.09
| Facility | AS | $271.67 | $2,575.09 | $2,575.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,392.00 / $2,412.36 / $9,100.51
| Facility | | $1,392.00 | $2,412.36 | $9,100.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |